involved 1,455 of the original participants, all of whom had no known heart or kidney disease. Information on health indicators were collected once again. Analysis determined that 91 people who had normal glucose levels in 1996 had developed pre-diabetes since then.

Levels of cystatin C then were measured in the blood samples taken at baseline of these 91 and were compared to cystatin C levels in samples from 273 participants from the original cohort who had not developed pre-diabetes.

Results showed a direct link between those with the highest levels of cystatin C and the development of pre-diabetes, said Donahue. The association didn't change when factors that traditionally are related to development of diabetes such as weight, amount of blood glucose at baseline, smoking history, high blood pressure or alcohol use were considered, he noted.

"Pre-clinical signs of renal impairment may occur before or coincident with pre-diabetes," Donahue said. "These findings may suggest that those who have pre-diabetes also should be screened for early signs of kidney impairment, which itself is a major chronic illness and cause of much morbidity and mortality."

The study was supported by a grant to Donahue from the National Institute of Diabetes and Digestive and Kidney Diseases.


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